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Qualitative Methodology (qualitative + methodology)
Selected AbstractsPredictors of Success in Individuals with Learning Disabilities: A Qualitative Analysis of a 20-Year Longitudinal StudyLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 4 2003Roberta J. Goldberg The research described here is part of a larger longitudinal project tracing the lives of a group of individuals with learning disabilities who attended the Frostig Center more than 20 years ago. The purpose of the larger project has been to identify variables that predict successful outcomes for adults with learning disabilities. This article focuses on the qualitative findings obtained using an ethnographic approach to analyzing in-depth interviews with participants. Six previously identified "success attributes" (self-awareness, proactivity, perseverance, appropriate goal setting, effective use of social support systems, and emotional stability/emotional coping strategies) were further defined. Using qualitative analysis, significant components of the success attributes that differentiated the successful from unsuccessful groups were identified, and changes over time were revealed. In addition, the following new themes were identified: (1) the learning disability exerted a critical influence across the entire lifespan; (2) there were differences in participants' family functioning; and (3) there were differences in participants' social relationships. Support for the salience of the success attributes and the additional themes to the participants is given in the form of direct quotations from the corpus of interview transcripts. Qualitative methodologies are stressed throughout the study for the purpose of obtaining an "insider's view" of LD. [source] Being ,fat' in today's world: a qualitative study of the lived experiences of people with obesity in AustraliaHEALTH EXPECTATIONS, Issue 4 2008Samantha L. Thomas PhD Abstract Objective, To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity. Design, Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index ,30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included. Results, Seventy-six individuals (aged 16,72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ,blame' against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight. Discussion and Conclusion, There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities. [source] The effects of cannabis abuse on the symptoms of schizophrenia: Patient perspectivesINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2008William F. Costain ABSTRACT:, This study explored explanatory models used by individuals with schizophrenia in relation to continuing cannabis abuse. Cannabis is known to exacerbate positive symptoms, compound the effects of negative symptoms, and lead to relapse, having a negative effect upon quality of life. If this is so, why would people choose to continue the drug use? Most previous studies exploring this phenomenon have used quantitative methodology where the questions asked have been preset by the researchers and the subjective experience of the patient has been minimized. Qualitative methodology was utilized in this study in order to give voice to the patients' perspectives, and contribute to the knowledge of the frameworks of meanings employed by patients. The majority of participants in this study did not perceive that they had a mental illness and they held strong beliefs regarding the usefulness of cannabis. They gave explanations for their continuing cannabis use that expanded the understanding from previous studies. These included that they sought the drug effects of cannabis use for clarity of voices, control of symptoms, to feel normal, perceived improvement in cognitive function, reduced psychological pain and increased energy. These beliefs may influence a person's adherence with treatment and their future cannabis use. This research has implications for clinical practice as clinicians may lack insight into the importance of the phenomenological beliefs of a person with schizophrenia. This lack of insight by the clinician into the phenomenological beliefs may impact on the development of a therapeutic relationship. [source] The relationship between healthcare professionals and the parents of chronically ill children: negotiating the boundaries between dependence and expertiseINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2007Alda Hummelinck senior clinical pharmacist Objective Mutual respect and understanding between parents and healthcare professionals are fundamental to the realisation of a partnership in the provision of care to chronically ill children. The aim of this study was an exploration of parents' perspectives on their relationship with healthcare professionals and their involvement in decisions about their child's care. Setting The paediatric department of a district general hospital in the West Midlands, England. Method Qualitative methodology using semi-structured interviews with 27 parents from 20 families with a chronically ill child. Key findings In the time following the child's diagnosis, parents' attitudes towards healthcare professionals often moved from reliance and trust to scepticism and suspicion. This change in attitude derived from their experience of inadequate communication and perception of professionals' failure to understand the reality of the intense and relentless demands and challenges that confront families providing care for a chronically ill child. Parents tended to be initially accepting and deferential to professional expertise. Over time, however, as their experience and confidence increased, they often desired a greater involvement in decisions about treatment and care. This transition, between initial, or episodic, dependency and active partnership, was often not recognised or accommodated by professionals. It was difficult for both parties to negotiate the transition from parents' dependency on health professionals to becoming more independent managers of care. Conclusions Professionals should be aware of parents' preferred and changing level of involvement in care and decision making, and endeavour to accommodate these throughout the process of providing care for chronically ill children. [source] Value choices and considerations when limiting intensive care treatment: a qualitative studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2009K. HALVORSEN Background: To shed light on the values and considerations that affect the decision-making processes and the decisions to limit intensive care treatment. Method: Qualitative methodology with participant observation and in-depth interviews, with an emphasis on eliciting the underlying rationale of the clinicians' actions and choices when limiting treatment. Results: Informants perceived over-treatment in intensive care medicine as a dilemma. One explanation was that the decision-making base was somewhat uncertain, complex and difficult. The informants claimed that those responsible for taking decisions from the admitting ward prolonged futile treatment because they may bear guilt or responsibility for something that had gone wrong during the course of treatment. The assessments of the patient's situation made by physicians from the admitting ward were often more organ-oriented and the expectations were less realistic than those of clinicians in the intensive care unit who frequently had a more balanced and overall perspective. Aspects such as the personality and the speciality of those involved, the culture of the unit and the degree of interdisciplinary cooperation were important issues in the decision-making processes. Conclusion: Under-communicated considerations jeopardise the principle of equal treatment. If intensive care patients are to be ensured equal treatment, strategies for interdisciplinary, transparent and appropriate decision-making processes must be developed in which open and hidden values are rendered visible, power structures disclosed, employees respected and the various perspectives of the treatment given their legitimate place. [source] Impact of caring for a school-aged child with a disability: Understanding mothers' perspectivesAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2010Helen Bourke-Taylor Aim:,Children with a disability are reliant on a capable, healthy and well-resourced carer. Most often the child's mother provides the care that ensures the child's health, service access and community integration are attended to successfully. Through in-depth interviews with mothers and professionals, this study explores issues that challenge the mother's performance in her very important role as a caregiver. Method:,Qualitative methodology(n = 8)resulted in verbatim transcriptions that were analysed and categorised, and common themes were derived. Results:,Participants identified a multitude of challenges related to issues surrounding the child, maternal characteristics, the family, services and the community. Emotional distress and mental health issues were reported. Conclusion:,Many aspects of caregiving can be relentless and challenging. Occupational therapy clinical implications aimed at supporting mothers and their children are discussed. [source] Qualitative Data Collection and Analysis Methods: The INSTINCT TrialACADEMIC EMERGENCY MEDICINE, Issue 11 2007William J. Meurer MD Patient care practices often lag behind current scientific evidence and professional guidelines. The failure of such knowledge translation (KT) efforts may reflect inadequate assessment and management of specific barriers confronting both physicians and patients at the point of treatment level. Effective KT in this setting may benefit from the use of qualitative methods to identify and overcome these barriers. Qualitative methodology allows in-depth exploration of the barriers involved in adopting practice change and has been infrequently used in emergency medicine research. The authors describe the methodology for qualitative analysis within the INcreasing Stroke Treatment through INteractive behavioral Change Tactics (INSTINCT) trial. This includes processes for valid data collection and reliable analysis of the textual data from focus group and interview transcripts. INSTINCT is a 24-hospital, randomized, controlled study that is designed to evaluate a system-based barrier assessment and interactive educational intervention to increase appropriate tissue plasminogen activator (tPA) use in ischemic stroke. Intervention hospitals undergo baseline barrier assessment using both qualitative as well as quantitative (survey) techniques. Investigators obtain data on local barriers to tPA use, as well as information on local attitudes, knowledge, and beliefs regarding acute stroke treatment. Targeted groups at each site include emergency physicians, emergency nurses, neurologists, radiologists, and hospital administrators. Transcript analysis using NVivo7 with a predefined barrier taxonomy is described. This will provide both qualitative insight on thrombolytic use and importance of specific barrier types for each site. The qualitative findings subsequently direct the form of professional education efforts and system interventions at treatment sites. [source] Parent's involvement in decisions when their child is admitted to hospital with suspected shunt malfunction: study protocolJOURNAL OF ADVANCED NURSING, Issue 10 2009Joanna Smith Abstract Title., Parent's involvement in decisions when their child is admitted to hospital with suspected shunt malfunction: study protocol. Aim., This paper outlines the protocol for a study aimed at exploring parent's involvement during professional,parent interactions and decisions about their child's care in the context of suspected shunt malfunction. Background., Hydrocephalus is a long-term condition treated primarily by the insertion of a shunt that diverts fluid from the brain to another body compartment. Shunts frequently malfunction, and parents of children with shunted hydrocephalus are responsible for recognizing and responding to shunt complications. Parents feel that interactions with professionals when they seek healthcare advice for their child do always not encourage active participation in care decisions. Methods., The study design is based on qualitative methodologies: a combination of conversation analysis applied to consultation recordings of professional,parent interactions when a child is admitted to hospital with suspected shunt malfunction, and semi-structured follow-up interviews with the same participants within 2 weeks of the consultation. Participants., This is a prospective study and participants will be purposefully selected. Parents of children who have been admitted to hospital with suspected shunt malfunction and healthcare professionals responsible for the initial assessment of the child will be invited to participate. Discussion., The study will identify how decisions about a child's care are negotiated between parents and healthcare professionals at key stages of the care pathway. In addition, examining interactions between healthcare professionals and parents may identify approaches that support or hinder parents in contributing to the decision-making processes when they seek advice from healthcare professionals. [source] ,Best research practice': in pursuit of methodological rigourJOURNAL OF ADVANCED NURSING, Issue 3 2001Frances Maggs-Rapport BA MPhil CertEd FRSA ,Best research practice': in pursuit of methodological rigour Rationale.,This paper is based on the rationale that misuse of methodological notions in research publications lays research studies open to criticism and dismissal. Aim.,In search of ,best research practice', this paper aims to examine the different qualities of four major qualitative methodologies: ethnography, descriptive phenomenology, interpretative phenomenology/hermeneutics and critical social theory. Design.,The study presents a critical overview of methodological decision-making, illustrating the sorts of issues researchers must consider in order to justify to the readership and to themselves the employment of a particular methodology. This is presented alongside a general overview of qualitative research and a précis of each of the major qualitative methodologies. The paper describes the methodologies, salient features, and examines methodological similarities and differences. The paper concludes by examining the need for methodological rigour within the framework of the National Health Service (NHS) Executive's drive for evidence-based practice in health care. Recommendations.,It is hoped that the paper will stimulate a deeper exploration of methodological rigour in future research publications. [source] Working to Make Interdisciplinarity Work: Investing in Communication and Interpersonal RelationshipsJOURNAL OF AGRICULTURAL ECONOMICS, Issue 2 2006Mariella Marzano Abstract In this paper, we apply qualitative methodologies to explore the practice of interdisciplinary research. The UK's Rural Economy and Land Use (RELU) Programme aims to advance understanding of the challenges faced by rural areas through funding interdisciplinary research to inform future policy and practice on management choices for the countryside and rural economies. Addressing the challenges faced by rural areas often requires a combination of different perspectives, involving research to address subjects that may lie beyond the skills of individual researchers. An interdisciplinary approach requires the integration of both data/information and the experiences and perspectives of different people (natural/social scientists, local people and policy-makers). We focus here on the processes involved in making interdisciplinarity work, documenting the experiences, perceptions, ideas and concerns of researchers working in interdisciplinary projects (specifically two EU-funded projects but also the first wave of RELU projects). A key finding from this research is that interdisciplinarity requires conscious effort, time and resources for the development of interpersonal relationships to enhance effective communication and thus successful collaboration. [source] Lecturer practitioners in UK nursing and midwifery: what is the evidence?JOURNAL OF CLINICAL NURSING, Issue 7 2004A systematic review of the research literature Background., Lecturer practitioner roles have been widely established in the UK, and are seen as having the ability to overcome the theory,practice gap in nursing, as well as offering other benefits including functioning as a link between education and practice. Aims and objectives., This article systematically reviews the research literature on UK lecturer practitioner roles in nursing and midwifery, in order to construct a picture of the themes that emerge from their national implementation. Conclusions., Only eight published research studies meeting the inclusion criteria were identified in journals, and five more included from the ,grey literature', totalling 13 suitable research reports. Of these 13 papers, six involved nurses and midwives. Key themes from the literature are outlined and discussed. There is an overwhelming preference for qualitative methodologies, although there is a strong argument for quantitative work in mixed-methods studies. Relevance to clinical practice. Lecturer practitioner roles can make an important contribution to nursing and midwifery education, but this is problematic. It is essential that managers clarify the purpose, responsibilities, support and review of lecturer practitioner roles if they are to be successful. [source] Underprivileged urban mothers' perspectives on scienceJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 6 2001Angela Calabrese Barton The purpose of this article is to report our findings from a qualitative study intended to develop our understandings of how inner-city mothers perceive science. Using qualitative methodologies, our analysis reveals that the mothers' perceptions can be grouped into four categories: perceptions of science as (a) schoolwork/knowledge, (b) fun projects, (c) a tool for maintaining the home and family, and (d) an untouchable domain. After we present these categories we compare our findings across categories to argue that those mothers who had spent time doing science with their children were more likely to have a more personal, dynamic, and inquiry-based view of science. We also argue that mothers' perceptions of science were more dynamic when they spoke about situations and contexts that were familiar to them, such as food, nutrition, and child care. We conclude the article with a discussion of the implications our findings have for science education reform. © 2001 John Wiley & Sons, Inc. J Res Sci Teach 38: 688,711, 2001 [source] Unmet Need for Family Planning in Developing Countries and Implications for Population PolicyPOPULATION AND DEVELOPMENT REVIEW, Issue 4 2000John B. Casterline Unmet need for family planning has been a core concept in international population discourse for several decades. This article reviews the history of unmet need and the development of increasingly refined methods of its empirical measurement and delineates the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in policy debates. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in-depth studies combining quantitative and qualitative methodologies. Of the causes of unmet need other than those related to access to services, three emerge as especially salient: lack of necessary knowledge about contraceptive methods, social opposition to their use, and health concerns about possible side effects. The article argues that the concept of unmet need for family planning, by joining together contraceptive behavior and fertility preferences, encourages an integration of family planning programs and broader development approaches to population policy. By focusing on the fulfillment of individual aspirations, unmet need remains a defensible rationale for the formulation of population policy and a sensible guide to the design of family planning programs. [source] Implementing Racial Anti-vilification Laws in New South Wales 1989-1998: A StudyAUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 1 2000Katharine Gelber Anti-vilification laws in Australia now have a decade-long history, yet remarkably little research has been conducted into their operation, nor has there been any systematic collation of outcomes. This paper seeks to fill this gap in the available research and also to make some proposals as to how to improve the legislation in practice. The paper reports on 10 years of complaints lodged under the NSW racial anti-vilification legislation, the oldest in Australia enacted in 1989. Other similar legislation followed in WA, SA, Tasmania. The results of all finalised case files from NSW since its inception in 1989 to the end of 1998 (568 cases) are examined. The research combines quantitative and qualitative methodologies. Some statistical data are provided, which are not relative; that is, there is no meaning available or implied between the different categories of outcome and each case has been interpreted separately. The qualitative method used provides an in-depth examination of specific case study outcomes in order to provide an accurate and sensitivepicture of the legislation in practice. The study may also be of use to researchers in other complaints-driven systems of regulation designed to support beneficial legislation. [source] A qualitative exploration of the perception of emotions in anorexia nervosa: A basic emotion and developmental perspectiveCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 4 2009John R. E. Fox Abstract Difficulties in emotional processing have long been regarded as a core difficulty within anorexia nervosa. Recent research and theory have started to highlight how eating disorder symptoms are often used to regulate painful emotions. However, there has been a lack of theoretical sophistication in how emotions have been considered within the eating disorders. This study was designed to use qualitative methodologies to address these inadequacies and provide a richer, more thorough account of emotions within anorexia nervosa. It used a grounded theory methodology to gather and analyse interview data from 11 participants who had a diagnosis of anorexia nervosa, being seen at a regional eating disorder service (both inpatient and day patient). The results highlighted two main overarching themes regarding the perception and management of emotions within anorexia nervosa: (1) development of poor meta-emotional skills; and (2) perception and management of emotion in anorexia nervosa. These two categories comprised of a significant number of components from the qualitative analysis, including difficulties with anger, meta-emotional skills and poverty of emotional environments while growing up. Once the data had been collected and analysed, links were made between the findings of this research and the current literature base.,Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: Practitoners needs to consider the importance of poor meta-emotional skills within anorexia nervosa. These meta skills appears to be more complicated than the simplistic notion of alexithymia. The routes to these difficulties in emotion appear to be drawn from a complicated developmental picture. The role of anger needs to be considered more fully in the psychotherapeutic work with people with anorexia nervosa. This study's findings suggest that increasing levels of anger may play a role in increased eating disorder symptomatology, especially vomitting. [source] Low-paid women: the impact of regulatory change in AustraliaINDUSTRIAL RELATIONS JOURNAL, Issue 5 2009Marian Baird ABSTRACT How is low-paid work experienced and understood by women at a time of marked regulatory change? Using a qualitative methodology, we examine women's experiences under Work Choices to assess the impact of the new laws. As in other neoliberal environments, we find that labour standards can have marked effects on low-paid workers; that heightened managerial prerogative leads to fear and insecurity; and that, in spite of all this, low-paid women have significant pride in their work. Furthermore, the results of regulatory change go beyond the workplace to affect women as carers, citizens and community members. [source] A qualitative study of mental health nurse identities: Many roles, one professionINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 6 2009John Hurley ABSTRACT The aim of the study was to clarify and build upon current understandings of mental health nurse (MHN) identity. The study adopted a framework of social constructionism and qualitative methodology. Semistructured interviews were conducted, which were thematically analyzed using Nvivo software. Twenty-five MHN were recruited across three geographical sites in the UK. Participants constructed a cluster of seven MHN identity characteristics that constituted a unique contribution to talk-based therapies. These themes of characteristics are: (i) the MHN as generic specialist; (ii) the MHN as adopting a service-user focus; (iii) the MHN as positioning and utilizing the personal self; (iv) the MHN as spending time with the service user; (v) the MHN as delivering talk-based therapies in versatile ways; (vi) the MHN as having an everyday attitude; and (vii) the MHN as having transferable skills. The distinctiveness, and thus, professional identity of mental health nursing, must be understood as a cluster of capabilities rather than a search for a singular point of difference. The breadth of capabilities employed by MHN highlights the value and worth of their contribution to service-user care. [source] An exploration of work-related stress in Northern Ireland community pharmacy: a qualitative studyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 5 2009Laura McCann Abstract Objectives The aim of this study was, through qualitative methodology, to explore the factors which contribute to job-related stress in community pharmacy in Northern Ireland. Methods All community pharmacists in Northern Ireland were invited to participate in one-to-one semi-structured interviews. Interview schedules explored pharmacists' attitudes to job-related stress and the situations that may contribute to stress. All interviews took place at participants' work sites between December 2007 and April 2008, were audio-taped, transcribed verbatim, read independently by the authors and analysed using thematic analysis. Key findings Seventeen pharmacists participated in the interviews. The main themes that emerged in relation to job-related stress were workplace issues, issues regarding professional expansion, recognition and responsibility, and a demanding public. Although there was general support for development in community pharmacy, this was tempered by concerns as to how expectations would be met and how all services would be delivered. Conclusions The themes that emerged from this work reflect what was reported from a survey conducted in 2007 and reinforce the tension between developments in practice and the ability to deliver. Developments in professional practice can be positive; however, commissioners and policy-makers need to consider whether community pharmacists have the infrastructure in terms of environment, personnel and multi-professional support to deliver what is required of them. [source] Professional competence: factors described by nurses as influencing their developmentINTERNATIONAL NURSING REVIEW, Issue 1 2006R. Tabari Khomeiran bs mscn phd Aim:, To discuss the results of a study that explored factors that may influence competence development. Background:, Competence, a controversial issue in health care settings, affects many aspects of the nursing profession, including education, practice and management. Although a number of research and discussion papers have explored the issue, in particular the meaning and assessment of nursing competence, to date little research has explored factors identified by nurses themselves as influencing their development of professional competence. Methods:, A purposive sample of 27 registered nurses was recruited from two university-affiliated hospitals. Data collection was by tape-recorded semi-structured interviews. Interviews were transcribed verbatim and analysed according to the qualitative methodology of content analysis. Findings:, Six descriptive categories were identified from the data: experience, opportunities, environment, personal characteristics, motivation and theoretical knowledge. Conclusions:, The findings suggest that the factors influencing the process of developing professional competence in nursing extend across personal and extra-personal domains. An understanding of these factors may enhance the ability of nursing managers and educators to enable student and qualified nurses to pursue effective competency development pathways to prepare them to provide a high standard of care. These findings, which may have important implications for nursing practice, management and education, are being further tested in a larger study. [source] Student characteristics and subculture trends in interpersonal skills workshopsINTERNATIONAL NURSING REVIEW, Issue 3 2002C ert E d, J. Gilmartin P h D Abstract The aim of this study was to explore the experiences of student nurses when learning interpersonal skills and to examine the impact of small group work. A qualitative methodology was used. The sample comprised 50 student nurses who were undertaking the preregistration diploma course. In-depth interviews were employed to collect the data. The findings indicated that many students resisted learning owing to a range of personal characteristics that influenced the learning process. A student typology was constructed which highlighted four types of student characteristics that emerged from the data. Significant characteristics relating to each type of student behaviour are emphasized. This report also combines the student typology with the emergence of three distinct subcultures that frequently both interrupt and enhance learning. In presenting the subcultures the implications for group work are considered in conjunction with study limitations. [source] Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature reviewJOURNAL OF ADVANCED NURSING, Issue 8 2010Claire RashidArticle first published online: 2 JUL 2010 rashid c. (2010) Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing,66(8), 1658,1670. Abstract Aim., This paper presents an integrative literature review of studies exploring the benefits and limitations of the recent expansion of the clinical role of nurses working in general practice in the United Kingdom. Background., Similar clinical outcomes and high levels of satisfaction with consultations undertaken by nurse practitioners compared to general practitioners in primary care have been reported in a Cochrane review [Cochrane Database of Systematic Reviews (2004) vol. 5, p. CD001271]. Since then, nurse consultations have increased considerably as general practitioners have delegated part of their clinical workload to other general practice nurses. However, whether all general practice nurses can fulfil this extended role remains open to question. Method., An integrative review was performed. Nine electronic databases were searched. UK studies were included if they were published after the previous Cochrane review, i.e. between 2004 and 2009. Results., Eight studies were identified, most using qualitative methodology. The evidence suggested that the changes in nurses' role have been predominantly driven by the perceived increase in workload arising from the new general practitioner contract. Delegating work to nurses provided a means of organizing workload within a practice without necessarily allowing patient choice. Patients generally thought that all general practice nurses would be able to deal with simple conditions, but they would prefer to consult with a general practitioner if they thought it necessary. There were concerns about nurses' knowledge base, particularly in diagnostics and therapeutics, and their levels of training and competence in roles formerly undertaken by general practitioners. Conclusion., There have been few studies in this key area of healthcare policy. There is a need for better training and support for nurses undertaking roles in consultation and for patients' views to be better represented. [source] The Use of Physical Interventions with People with Intellectual Disabilities and Challenging Behaviour , the Experiences of Service Users and Staff MembersJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2005Sarah Hawkins Background, The views of both service users with intellectual disability and their support staff on the use of physical interventions are largely unknown. The research that does exist describes a largely negative pattern of responses. The present study aimed to explore the personal impact of receiving and implementing physical interventions, and also how service users and staff felt the use of such procedures impacted on each other. Method, Eight service user/staff pairs were interviewed about their experiences of physical intervention within 1 week of their mutual involvement in a behavioural incident requiring restraint use. A qualitative methodology was employed to obtain views on a non-pain compliance approach to physical intervention. Results, Service user and staff experiences were intrinsically linked, highlighting the interactional nature of physical interventions. It was apparent that experiences of physical intervention were dependent on far more than the application of techniques alone. Conclusions, Participants' accounts were primarily negative. Service user and staff experiences were clearly affected by their appraisals of each other's behaviour throughout the physical intervention process. [source] Meaning and measurement: an inclusive model of evidence in health careJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2001Ross E.G. Upshur Abstract Evidence-based approaches are assuming prominence in many health-care fields. The core ideas of evidence-based health care derive from clinical epidemiology and general internal medicine. The concept of evidence has yet to be analysed systematically; what counts as evidence may vary across disciplines. Furthermore, the contribution of the social sciences, particularly qualitative methodology, has received scant attention. This paper outlines a model of evidence that describes four distinct but related types of evidence: qualitative-personal; qualitative-general; quantitative-general and quantitative-personal. The rationale for these distinctions and the implications of these for a theory of evidence are discussed. [source] Psychological functioning in families that blame: from blaming events to theory integrationJOURNAL OF FAMILY THERAPY, Issue 4 2005Ceri Bowen Blaming events in therapy were used as a focus for discussions with family therapists in order to examine their construal of the therapeutic process when working with families who blame. Interview transcripts were used as data which were analysed using a qualitative methodology, with a view to building a theoretical model. We present an exploratory model that allows therapists to position their therapy within a broader framework of psychological approaches. When prompted by a video-clip of blaming from the therapy setting, therapists tended to categorize current difficulties in terms of fear and control issues from past relationships and consequent underlying beliefs, and they also described the resultant negative outlook as a direct challenge to therapist idealism. Interestingly, the two themes that emerged from the interview data with the most categories and quotes were ,unhealthy allocation of responsibility for problems', which is arguably the main source of overt blaming, and ,family identity and cohesion', so often a point of contention during therapy. [source] Post-stroke fatigue: qualitative study of three focus groupsOCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2010Nancy A. Flinn Abstract Fatigue affects many persons after cerebrovascular accident, particularly those with mild stroke. A qualitative methodology using focus groups with 19 community-living post-stroke survivors was utilized to explore the occupational impact of fatigue as communicated by the participants. Although self-report of a small sample of the United States' post-stroke population will have limitations in generalizability, this study identifies specific health-related quality of life issues that can occur with post-stroke fatigue. The participants felt unprepared for the fatigue phenomenon and struggled to adapt, with fatigue having a debilitating influence upon daily occupational performance and roles, including social participation, return to work, driving, reading and sleeping. The participants indicated that exercise (such as walking and water aerobics) and use of assistive technology were helpful strategies in reducing fatigue. The occupational performance and role impact identified by participants in this study can inform the design of effective occupational therapy interventions and further quantitative study of persons with post-stroke fatigue. Copyright © 2009 John Wiley & Sons, Ltd. [source] Reconciliation in Londonderry: The Challenges and Constraints Experienced by Protestant ClergyPEACE & CHANGE, Issue 4 2006Neil Southern Northern Ireland is a place that is more peaceful due principally to the cessation (although imperfect) of republican and loyalist paramilitary violence in 1994. While the violent excesses of ethnic dispute in Northern Ireland no longer saturate media reports, there remains much fear, distrust, and insecurity between Protestant and Catholic communities. This article conducts a microexamination of church-led attempts at cross-community reconciliation by Protestant clergy in the city of Londonderry. These attempts are often hampered because of factors that affect both the clergy and the wider Protestant community within which the clergy discharge their pastoral duties. The constraints in their ecumenical activity and interfaith contacts that Protestant clergy experience highlight other factors that hinder the evolution of a more peaceful society. It also causes one to reflect carefully upon the effectiveness of ecumenism and interfaith dialogue as a model for advancing society towards peace and reconciliation. The findings of this paper are based upon a qualitative methodology that involved eight semistructured interviews with clergy of the Church of Ireland, Presbyterian, and Methodist traditions. [source] Maturity and adherence in adolescent and young adult heart recipientsPEDIATRIC TRANSPLANTATION, Issue 3 2006Carol S. Stilley Abstract: Background: Pediatric transplant (txp) teams note high rates of non-adherence and risky behaviors linked to morbidity and mortality among adolescent and young adult recipients. Clinicians and parents alike report symptoms of social immaturity and failure to appreciate consequences of risky behavior; relationships between the two have not been studied in this population. Method: This two-phase mixed method study examined adherence, high-risk behaviors, and maturity in a sample of 27 heart recipients, aged 15,31, who underwent transplantation in childhood or adolescence at Children's Hospital of Pittsburgh. All subjects completed a projective ego development measure and a questionnaire about adherence to the post-txp regimen. Nine recipients, purposely selected for good or poor adherence according to criteria determined by the transplant team and matched on age, participated in phase 2 qualitative interviews and mood assessments. Results: Sixty-three percent of the phase 1 sample missed medications, 67% missed appointments, 11% smoked, 37% had difficulty with diet, 89% exercised infrequently, 33% had tattoos, 26% had more than two body piercings, and 11% used street drugs. Six themes and a core construct of maturity were identified with qualitative methodology. Poor adherers were less mature on every theme and consistently scored at a less mature level on the projective measure of ego development. Chronological age was not related to the level of maturity in qualitative or projective data. Most interview subjects reported high levels of anxiety, and two reported clinically significant levels of depression and anger; mood was not related to adherence. Conclusions: Non-adherence and high-risk behaviors are prevalent among adolescent and young adult heart recipients. Level of maturity appears to be associated with ability to adhere to the treatment regimen and avoid high-risk behaviors. [source] Dimensions of quality of life and psychosocial variables most salient to colorectal cancer patientsPSYCHO-ONCOLOGY, Issue 1 2006Jeff Dunn Abstract Colorectal cancer is one of the most common invasive cancers, and is responsible for considerable physical and psychosocial morbidity. Understanding the quality of life experienced by colorectal cancer patients is essential for evaluating the full impact of the disease on individuals, their families and their communities. Patient perspective is essential in establishing a proper understanding of the quality of life of colorectal cancer patients. Despite this, few studies have employed a qualitative methodology to explore quality of life issues for colorectal cancer patients. A review of the literature identified only seven qualitative studies pertaining to quality of life issues for colorectal cancer patients, a surprising finding given the prevalence of this cancer. Accordingly, this study sought to build on the findings of previous qualitative research by providing descriptive data on the quality of life and psychosocial variables most salient to colorectal cancer patients. Six core themes emerged from interview and focus group data: Satisfaction with diagnosis and treatment; support (including information provision); quality of life; benefits of diagnosis; making sense of the cancer experience; and coping strategies. The information derived from this study will help inform the development of supportive care services to address the needs of the increasing number of people diagnosed with colorectal cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source] Public policy and privatisation: the case of the Qatari experiencePUBLIC ADMINISTRATION & DEVELOPMENT, Issue 4 2007Ahmed Mustafa Elhussein Mansour Abstract This article uses a qualitative methodology employing the elite model to describe and analyse the complex interplay of political and economic factors in the privatization experience of the state of Qatar. The article begins by providing a theoretical framework for privatisation in the context of public policy and classifying policies of privatisation into two categories: macro- and micro-privatisation. The second part uses this framework to discuss the factors that gives the Qatari experience its distinguished flavour. These factors include: elite legitimacy and social culture, bureaucratic power, international pressure and patron,client networks. Copyright © 2007 John Wiley & Sons, Ltd. [source] Barriers to physical activity participation in older Tongan adults living in New ZealandAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2006Gregory S Kolt Objectives:,To identify perceived barriers to physical activity participation in older Tongan adults living in New Zealand. Methods:,Focus groups with 24 sedentary older Tongans to examine the role of physical activity in Tongan culture, perceived barriers to and benefits of physical activity participation, and how to encourage physical activity participation. Data were analysed using a descriptive qualitative methodology. Results:,The perceived role of physical activity centred on traditional ways of living, recreational and outdoor pursuits, and house chores and activities of daily living. Physical activity barriers included education and motivation, physical environment, family environment, physical and health issues and cultural expectations. Social, psychological, cognitive and health benefits of physical activity were identified, and it was suggested that the government, medical/health practitioners and church leaders were all important in encouraging increased participation. Conclusions:,Community-based programmes may be one way of encouraging physical activity in this population. [source] | |||||||||||||||||||||||||||||||||||||